By Jane Sarasohn-Kahn

Consumers, employers, payers and providers agree that information flows are critical to helping stem health care costs. While there is shared concern about health care costs, there is also a shared desire for more, accessible information and better online tools for managing it.

TriZetto’s report, Research Shows Healthcare Market Constituents Seek Information as Key to Solving the Affordability Crisis, surveys the landscape of stakeholders in American health care and lays out a rational approach to what the IT services firm calls integrated health care management.

TriZetto lays out five key themes that drive the imperative toward integrated health care management:

1. Health care affordability
2. Aligning incentives to change activities
3. Information access as king
4. The importance of leveraging information technology
5. Payers as change agents.

The table on the right illustrates that most consumers are concerned about health
costs. Consumers are particularly worried about their future costs of health care compared to the present, although 7 in 10 Americans are still concerned about the present state of health care costs.

Employers, payers and providers are also concerned about health costs. Providers in particular are facing growing costs in the form of increasing consumer bad debt, escalating administrative costs, and rising accounts receivables.

TriZetto suggests that improving communication between provider and patient on expected patient out-of-pocket costs would go a long way to improving care delivery and patient satisfaction. At a minimum, the inevitable sticker shock at discharge or point-of-payment could be avoided and patients could prepare in advance their payment strategies.

The big opportunity here, TriZetto concludes, is for integrated health management that would align incentives between patients, payers, providers and employers that nudge people to improve their lifestyle and health behaviors. The survey forecasts that in 2010, 38 percent of brokers, employers and payers will set health management goals in exchange for financial and other incentives for consumers.

Jane’s Hot Points: Consumers’ concern about costs seems somewhat intuitive, given that they do not really understand just how much employers are footing for their health care. Kaiser Family Foundation estimated that employers paid between $7,600 and $9,400 in 2007 for family health coverage. Clearly, based on the data in the table, consumers are significantly under-estimating the large contribution of their employers to family health. That 44% of employees don’t have a clue on this question identifies the clear need for Americans to get an education in Health Costs 101.

 Email This Post